Open AccessDiabetic neuropathy in combination with deficiency state
Author(s) -
O. E. Zinovyeva,
P. D. Egorov,
Viacheslav N. Novikov,
I. M. Lovchev
Publication year - 2022
Publication title -
medicinskij sovet
Language(s) - English
Resource type - Journals
eISSN - 2658-5790
pISSN - 2079-701X
DOI - 10.21518/2079-701x-2022-16-2-95-99
Subject(s) - medicine , pathogenesis , polyneuropathy , diabetes mellitus , peripheral neuropathy , metformin , type 2 diabetes , diabetic neuropathy , ataxia , vitamin b12 , b vitamins , complication , gastroenterology , vitamin b6 , advanced glycation end product , endocrinology , vitamin , glycation , psychiatry
Diabetic polyneuropathy (DPN) is the most common neurological complication of diabetes mellitus. The most common type of DPN is distal symmetric, predominantly sensory, polyneuropathy. Chronic hyperglycemia plays a key role in DPN pathogenesis. It leads to accumulation of advanced glycation end products in tissues, including vasa nevrorum that supply peripheral nerves with oxygen. Thorough diagnostic approach to DPN is crucial for early detection of this condition. Early diagnosis and treatment slow DPN progression rates and leads to symptom reduction. Long-lasting metformin therapy may cause vitamin B deficiency. This article describes a comprehensive approach to the treatment of patient with type 2 diabetes and symptomatic diabetic and vitamin deficiency neuropathy. Apart from DM therapy, the patient received pathogenesis-based therapy of DPN with alpha-lipoic acid and a combination of vitamins B1, B6 and B12. Such pathogenesis-based approach has shown to decrease severity of DPN symptoms and reduce sensory ataxia.